Terminolgy
Here we define some popular medical & health insurance terminology.
NB. When terms are used in PMI policy documents, the insurer’s own definitions should be referred to and not our definitions below which are only provided for guidance purposes.
Acute Conditions
A disease, illness or injury that is likely to respond quickly to treatment which aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery
AlternativeTherapy
Increasingly popular – can include homeopathy, acupuncture, physiotherapy and traditional Chinese medicine.
Cancer
A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue.
CashPlan
Reimbursement of insured costs
Chronic condition
‘A disease, illness, or injury that has one or more of the following characteristics:-
• it needs ongoing or long-term monitoring through consultations, examinations, check-ups, and / or tests;
• it needs ongoing or long-term control or relief of symptoms;
• it requires your rehabilitation or for you to be specially trained to cope with it;
• it continues indefinitely;
• it has no known cure;
• it comes back or is likely to come back.’
Claims Procedures
The procedure for making a claim – many insurers can now do this over the phone rather than by forms
Consequence of non-disclosure
It is essential when describing your medical history that a full disclosure is made or claims maybe annulled due to non-disclosure
Day patient
A patient who is admitted to a hospital or day patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight
Diagnostic tests
Investigations, such as X-rays or blood tests, to find or to help to find the cause of your symptoms
Excess
This is the (often nominal) amount that the insured individual agrees to pay towards the cost of any treatment required. It is usually only paid once on the initial claim per person per policy year. Your lowest excess is typically £200 (May, 2007).
Health / medical insurance
Is there a difference between health and medical insurance? The answer is ‘no’ as they tend to be used interchangeably. You can consider both of them to be exactly the same thing when reading definitions on MediCube, however they may differ on insurance policy documents from the insurers themselves.
In-patient
This is an individual who is admitted to hospital for medical treatment who has to stay for one (or possibly more) night(s).
Moratorium
This is where the individual applying for medical cover is not required to declare his or her medical history at the application stage, but any condition suffered in the previous 5 years (can differ) will eventually be covered if no symptoms, medication tests / advice or treatment is received for that condition for a further period of two years (can differ).
NHS Cash Benefit for Treatment
This is a ‘money back’ payment from your insurer for choosing to have NHS treatment instead of private treatment.
Nurse
A qualified nurse who is on the register of the Nursing and Midwifery Council (NMC) and holds a valid NMC personal identification number.
Out patient
An individual treated in a hospital, clinic or consulting room – but not as a day or in-patient.
PMI
Private medical insurance (explained in full in our guides section).
Pre-existing conditions
Any conditions e.g. illness or disease for which the applicant has received treatment / medication or experienced symptoms before the insurance started.
Treatment
Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury.
It is recognised that some firms use the term 'active treatment'. This has the potential to confuse customers given the current agreed definition of treatment. If firms do use the term it must be accompanied by a specific definition.