Private Health Insurance FAQs - Your Questions Answered

If after reading these frequently asked questions you need more information, or have any unanswered questions, please contact us. We will be happy to help.

What is Private Health Insurance?

The private health insurance policies offered by General & Medical aim to fund private medical treatment of acute conditions. The policies will cover the costs of eligible treatment within the UK, up to the limits of your chosen cover, by our recognised consultants, medical practitioners or therapists. The benefits include cover for initial private consultations, in-patient, out-patient and day-patient investigations and treatment up to the limits of your chosen cover.

Our private health insurance policies provide cover for eligible treatment at any of the Participating Hospitals within the hospital choice you make. These are ‘First Choice’, ‘Freedom’ and ‘Premium’. The Participating Hospitals within any level may change from time to time.

Who provides the policy?

Where the benefits of your policy are insured, different insurers may underwrite them. For clarity we have detailed which insurers underwrite the benefits you may have, in the table below.

Private Health Insurance Underwriter Table

General & Medical Insurance Ltd is authorised and regulated by the Guernsey Financial Services Commission (GFSC).

General & Medical Finance Ltd is authorised and regulated by the Financial Conduct Authority (FCA).

What is the duration of my policy?

12 months unless specified otherwise. You will be sent your renewal documents before your scheme continues for another year. You should review the renewal documents to make sure the cover and policy remains suitable for your needs. Worldwide Travel policies run, renew and end with your private medical insurance policy but can be cancelled separately at renewal.

How can I pay my premium?

You have a choice of payment method

  • Monthly by direct debit which is secure and an easy way to spread the cost over the year
  • Annually by direct debit, debit/credit card, BACS or cheque

Does it cost more to pay monthly?

No. Unlike some other insurance companies General & Medical do not charge their clients extra, or any form of interest, to pay their premiums monthly. This is one more reason to choose General & Medical.

Are there any age limits?

You may join a General & Medical scheme as an individual from the age of 16 up to your 75th birthday. Once covered there is no upper age limit.

Children under the age of 16 must be added to an adults policy. Children are classed as a child up to their 21st birthday, or their 26th birthday if they remain in full time education. Proof of full time education must be provided.

Will my premium go up at renewal?

We review your premiums annually to reflect the overall cost of claims and medical inflation. Our schemes are priced using age bands, reflecting that people are more likely to claim as they get older. This means that you could see an age-related increase in your premium in addition to our general review.

Your premium can be influenced by other factors such as the availability of new treatments, medical technologies and any claims made on your scheme.

How do I make a claim on my private insurance policy?

You should contact your Health and Care Support Specialist before you see your consultant so that we can confirm your cover. Your Health and Care Support Specialist will be able to guide you through the process of claiming and let you know what is and is not covered. The full claims procedure is detailed in 'the Guide to your Health Scheme'.

Sometimes it is necessary for our underwriters to view a claimant’s medical history (in the form of their medical records), in order to fully assess the eligibility of the proposed claim.

In order for the underwriter to use their knowledge of medical conditions and any associated diseases or disorders to determine whether the claim has merit, it is necessary to view the complete medical history of the claimant.

This is where Private Medical Insurance (PMI) differs fundamentally from, for example, Life Insurance, whereby it may be possible to assess a claim or an application for Life Insurance by asking for details on a specific condition, or even just a specific time period in the persons medical history.

Occasionally a GP has misunderstood this important difference and has inadvertently prolonged the claims process by releasing information strictly in response to specific questions, which has caused unnecessary delays in the underwriters reaching their decision and this in turn causes anxiety to the claimant at a time when they may already be feeling unwell and vulnerable.

For this reason we always endeavour to ensure that GP’s understand that medical information requests in relation to PMI should not be confused with medical information requests in relation to Life Insurance, but cannot guarantee that a GP will always respond either as quickly as we would like, or as fully as we may need.

How do I make a claim on my Non-UK Travel Medical Policy?

To make a claim for emergency medical treatment whilst outside the UK please use the telephone numbers provided within your Certificate of Cover.

How do I make a claim on my Worldwide Travel Policy?

To make a claim for emergency medical treatment whilst outside the UK please use the telephone numbers provided within your Certificate of Cover. To make a claim on this insurance for any section other than emergency medical treatment whilst outside the UK, please contact us immediately on your return to the UK. A claim form will be sent to you for completion and return.

Can I cancel my policy?

You may cancel your policy by telephoning us, by email or in writing (see Contact Us for details).

You may cancel your policy during the 14 day cooling off period. This period commences on the day your cover starts or when you receive your policy documentation, whichever is the later. We will refund any premium paid at the date of cancellation, providing you have not used any of the services available on your cover and no claims have been made.

If you decide to cancel your cover before your renewal date and outside of the cooling off period, providing you have not used any of the services available on your cover or attempted to make any claims you can do this by giving us at least 30 days notice before the date on which you want your cover to cease. If you have incurred any claims costs, attempted to make a claim, used any of the services provided by your cover, or an incident has occurred which has led to a claim, or may yet lead to a claim against your policy, we will require you to pay any remaining unpaid balance of the full annual premium as shown on your most recent Certificate of Cover document. You will receive written confirmation from us that your cover has ceased and your cover will not continue beyond your cancellation date.

If you wish to cancel your cover at your renewal date you should tell us as soon as possible before your renewal date. Your cover will cease the day immediately prior to your policy renewal date. A 14 day cooling off period also applies at renewal, commencement of which is from your renewal date.

What do I do if I have a complaint?

To avoid misunderstandings, you must read the information supplied when taking out your cover. If you are unsure about any aspect of cover, you should contact your personal Health and Care Support Specialist. We’re here to help.

We are committed to providing a high level of service to all our clients but occasionally things can go wrong. If this happens, we will do what we can to put things right.