Coronavirus (COVID-19) information

 

 

We are closely monitoring the impact of COVID-19 on our members and will continue to update our guidance as the situation evolves.

The Financial Conduct Authority (FCA), has published consultations on what it expects from insurers in these exceptional circumstances.

We’ve created some online support below in response to this guidance, including the value your clients can continue to expect from their policy with us and the steps we have taken to ensure fair treatment of our members.

For members

Will you pay a claim on a life cover policy if I die of coronavirus?
Yes, we will assess a claim in the usual way.

Will you pay a claim on an income protection policy if I am unwell due to coronavirus?
Yes, we will consider claims. We will establish if your illness is preventing you from undertaking your own occupation. 

Will you pay a claim if I am self-isolating?
If you had an income protection policy in place before 12pm on 16 March 2020, we will consider making an ex-gratia payment outside the terms and conditions of the policy if you have received official medical guidance to self-isolate, from Public Health England, NHS 111 or a GP. 

For policy applications submitted on or after 16 March 2020, any claims for self-isolation (including medically advised self-isolation), will not be considered.

I am listed in the NHS ‘vulnerable’ group and have been advised to self-isolate. Will I be able to claim?
As a minimum we will consider paying for 14 days of self-isolation. We will then consider further a supplementary ex gratia payment depending on the individual circumstances.

Will you pay a claim if I travel abroad and have to self-isolate on my return?
All claims will be individually considered, but it is unlikely that we will make any ex-gratia payments if you travel overseas (to or from the UK) and are required to self-isolate as a result.

Will you pay a claim if my income reduces due to coronavirus or I am made redundant?
We wouldn’t be able to pay a claim in these circumstances. Our income protection policies are designed to cover a loss of income resulting from illness or injury, not as a result of economic factors.

If I claim for income protection in the future and my job or income has been affected by coronavirus, how will you assess it?
We will consider every situation individually. We normally assess a claim by gathering evidence of your personal taxable income in the 12 months immediately before your illness or injury, however where it is clear that coronavirus has interrupted your normal earnings we will take a common sense approach to your claim.

I would like to keep my policy but I am struggling to pay my premiums due to coronavirus. What are my options?
We are committed to helping you keep your insurance cover in place, please call us and we will talk through the options available.

What other support can you offer me?
With the NHS currently under immense pressure, our member benefits app, HealthWise, can give you direct access to medical experts via your smartphone or tablet. 

The HealthWise app can be downloaded from the App Store or Google Play. You will need your policy details in order to activate your HealthWise account.

Can I still use my health insurance plan?

Private facilities in the UK are now accepting patients, and we have seen an increase in the number of procedures being carried out. If you have a health concern you would like to discuss with us, please contact our claims team on 0300 123 3253 (+44 1392 36 35 36 from overseas) between 8am – 8pm Monday to Friday and 8am – 1pm on Saturdays.

We have set out the following steps to support you during this period.

Clinical Support Centre

We understand that you may still be worried about accessing care, so we’re pleased to let you know that you can continue to access the Clinical Support Centre for eligible claims. This provides virtual access to specialist consultations with some of the UK’s leading specialists and practitioners by telephone, video or online.

Members using the Clinical Support Centre will not have to pay any policy excess and the No Claims Discount (where applicable) won’t be affected, nor will out-patient benefits for consultations and diagnostics. Normal personal and policy exclusions still apply, however, and any treatment resulting from use of the service will need to be covered within your policy limits. To access the Centre, please contact our claims team on 0300 123 3253 or +44 1392 36 35 36 from overseas.

Impact on premiums

As expected, we’ve seen an increase in the number of health insurance claims as hospital procedures resumed after the pandemic. Members can now expect to access the full benefits that their policy provides, with demand for treatment significantly increasing.

We made a commitment that any surplus resulting from a reduction in claims would be returned to our members. This applies to members that bought one of the following policies before 1 April 2020; Health+, Health Cover for Me, Health Choices for Me, Health Essentials for Me, Exeter Care Preferred Plan, Exeter Care Low Cost Plan, RBS Plan, Shared Care, UK Plan and Prudential Medical Benefits Fund. This commitment was based on the expectation that we would pay less in health insurance claims than anticipated during the period when private hospitals were prioritising COVID-19 patients.

This is still our commitment, and we continue to calculate the cost of claims to allow a fair return to our members. We will continue to review claims experience for the remainder of 2021 as we expect that most of the treatment that was unable to be carried out during the pandemic will still take place.

Enhanced cash benefit

In response to the requisitioning of private hospitals by the NHS, we added a temporary ex-gratia benefit to health insurance policies. From 1 April 2020 - 31 March 2021, we offered an enhanced cash benefit of £500 per night to members who were treated without charge in either an NHS or private setting, for any eligible claim including COVID-19. At the end of June 2021, we paid over £1.6m in cash benefit to our members.

I would like to keep my policy but I am struggling to pay my premiums due to coronavirus. What are my options?
We are committed to helping you keep your insurance cover in place, please call us and we will talk through the options available.

What other support can you offer me?
With the NHS currently under immense pressure, our member benefits app, HealthWise, can give you direct access to medical experts via your smartphone or tablet.

Please note that HealthWise will be unable to provide any consultations related to COVID-19 as the NHS is ensuring that all COVID-19 treatment is centralised.

The HealthWise app can be downloaded from the App Store or Google Play. You will need your policy details in order to activate your HealthWise account.

For advisers

Have you changed your application questions?

Yes, we have introduced a new question:

Have you tested positive for coronavirus (COVID-19) in the last 2 years?

Are you offering virtual medical screenings?

We are currently trialling this with a number of life cover and income protection applicants and are contacting advisers whose clients may meet the criteria.

How are you complying with FCA guidance relating to COVID-19?

Product value

The FCA expects insurers to consider the value of their products in light of the exceptional circumstances arising out of coronavirus. We are still able to provide the contractual benefits that our members expect from their policies, giving valuable financial protection against the risks of death and ill health. Specific answers to questions around how members can claim on their policies at this time are covered in more detail below.

Customers in temporary financial difficulty

The FCA expects insurers to consider the support it can provide customers who are facing financial hardship as a result of coronavirus. We are committed to helping you and your client keep insurance cover in place; please call us and we will talk through the options available.

Will you pay a claim on a life cover policy if my client dies of coronavirus?

Yes, we will assess a claim in the usual way.

Will you pay a claim on an income protection policy if my client is unwell due to coronavirus?

Yes, we will consider claims. We will establish if your client’s illness is preventing them from undertaking their own occupation. 

Will you pay a claim if my client is self-isolating?

If your client had an income protection policy in place before 12pm on 16 March 2020, we will consider making an ex-gratia payment outside the terms and conditions of the policy if they have received official medical guidance to self-isolate, from Public Health England, NHS 111 or a GP.

For policy applications submitted on or after 16 March 2020, any claims for self-isolation
(including medically advised self-isolation), will not be considered.

If my client is listed in the NHS ‘vulnerable’ group and has been advised to self-isolate, will they be able to claim?

As a minimum we will consider paying for 14 days of self-isolation. We will then consider further a supplementary ex-gratia payment depending on the individual circumstances.

Will you pay a claim if my client travels abroad and has to self-isolate on their return?

All claims will be individually considered, but it is unlikely that we will make any ex-gratia payments if your client travels overseas (to or from the UK) and is required to self-isolate as a result.

Will you pay a claim if my client’s income reduces due to coronavirus or they are made redundant?

We wouldn’t be able to pay a claim in these circumstances. Our income protection policies are designed to cover a loss of income resulting from illness or injury, not as a result of economic factors.

If my client claims for income protection in the future and their job or income has been affected by coronavirus, how will you assess it?

We will consider every situation individually. We normally assess a claim by gathering evidence of your clients’ personal taxable income in the 12 months immediately before their illness or injury, however where it is clear that coronavirus has interrupted their normal earnings we will take a common sense approach to the claim.

What other support can you offer my clients?

With the NHS currently under immense pressure, our member benefits app, HealthWise, can give your clients direct access to medical experts via their smartphone or tablet. 

The HealthWise app can be downloaded from the App Store or Google Play. Your client will need their policy details in order to activate their HealthWise account.

How are you complying with FCA guidance relating to COVID-19?

Product value

The FCA expects insurers to consider the value of their products in light of the exceptional circumstances arising out of coronavirus. Given the impact that COVID-19 has had on private healthcare, we have detailed in the questions below the steps we have taken to ensure our members can still get value from their policies at this time.

Customers in temporary financial difficulty

The FCA expects insurers to consider the support it can provide customers who are facing financial hardship as a result of coronavirus. We are committed to helping you and your clients keep insurance cover in place; please call us and we will talk through the options available.

Can my client still use their health insurance plan?

Private facilities in the UK are now accepting patients, and we have seen an increase in the number of procedures being carried out. If your client has a health concern they would like to discuss with us, please ask them to contact our claims team on 0300 123 3253 between 8am – 8pm Monday to Friday and 8am – 1pm on Saturdays.

We have set out the following steps to support your clients during this period.

Clinical Support Centre

We understand that your clients may still be worried about accessing care, so we’re pleased to let you know that they can continue to access the Clinical Support Centre for eligible claims. This provides virtual access to specialist consultations with some of the UK’s leading specialists and practitioners by telephone, video or online.

Members using the Clinical Support Centre will not have to pay any policy excess and the No Claims Discount (where applicable) won’t be affected, nor will out-patient benefits for consultations and diagnostics. Normal personal and policy exclusions still apply, however, and any treatment resulting from use of the service will need to be covered within your clients’ policy limits. Members can access the Centre by calling our claims team on 0300 123 3253.

Impact on premiums

As expected, we’ve seen an increase in the number of health insurance claims as hospital procedures resumed after the pandemic. Members can now expect to access the full benefits that their policy provides, with demand for treatment significantly increasing.

We made a commitment that any surplus resulting from a reduction in claims would be returned to our members. This applies to members that bought one of the following policies before 1 April 2020; Health+, Health Cover for Me, Health Choices for Me, Health Essentials for Me, Exeter Care Preferred Plan, Exeter Care Low Cost Plan, RBS Plan, Shared Care, UK Plan and Prudential Medical Benefits Fund. This commitment was based on the expectation that we would pay less in health insurance claims than anticipated during the period when private hospitals were prioritising COVID-19 patients.

This is still our commitment, and we continue to calculate the cost of claims to allow a fair return to our members. We will continue to review claims experience for the remainder of 2021 as we expect that most of the treatment that was unable to be carried out during the pandemic will still take place.

Enhanced cash benefit

In response to the requisitioning of private hospitals by the NHS, we added a temporary ex-gratia benefit to health insurance policies. From 1 April 2020 - 31 March 2021, we offered an enhanced cash benefit of £500 per night to members who were treated without charge in either an NHS or private setting, for any eligible claim including COVID-19. At the end of June 2021, we paid over £1.6m in cash benefit to our members.



What other support can you offer my clients?

With the NHS currently under immense pressure, our member benefits app, HealthWise, can give your clients direct access to medical experts via their smartphone or tablet. 

Please note that HealthWise will be unable to provide any consultations related to COVID-19 as the NHS is ensuring that all COVID-19 treatment is centralised.

The HealthWise app can be downloaded from the App Store or Google Play. Your clients will need their policy details in order to activate your HealthWise account.