Medical underwriting for businesses in Indonesia

 

Full Medical Underwriting

Sometimes referred to as ‘FMU’

With this option, your employees will each need to complete a health questionnaire, and we will then advise them in writing about any endorsements which may be applied to the members cover. Pre-existing medical conditions would not be covered unless they have been declared to our underwriters within the employee application form and the underwriters have agreed to proceed without adding any exclusions or terms to the cover.

If you choose this option, employees who do have pre-existing medical conditions will know right from the start exactly which medical conditions will be excluded from cover.

Our requirements

• Business application form
• Employee application form (full medical declaration)

Your policy

Your William Russell plan will be shaped around the requirements of your business and will clearly state any exclusions that apply.

 

Moratorium Underwriting

Sometimes referred to as ‘MORI’

With moratorium underwriting, the employer will need to complete an application form and a short health questionnaire on behalf of the employees within the group scheme. Individual employees will also need to complete an application form, and there will be no medical questionnaire required.

Pre-existing conditions which have required treatment, medication or advice, or for which the employee has suffered symptoms (whether or not they have received a diagnosis) during the 24 month period preceding the commencement of the employees’ plan will not be covered.

At point of claim, additional information may be requested in order for the claims team to assess whether the condition is pre-existing or not.

After a continuous 24-month period we may consider claims for pre-existing conditions provided the employee has been symptom, treatment, medication and advice free during that period. Long-term and serious medical conditions which are likely to continue to need regular or periodic treatment, testing, medication and/or medical advice, are unlikely to be covered by a moratorium policy.

Our requirements

• Business application form
• Employee application form (with no medical questionnaire)

Your policy

This type of underwriting means your policy may include cover for conditions that members have suffered from in the past, after two years with no symptoms, medical advice or treatment.

 

Continued Personal Medical Exclusions

Sometimes referred to as ‘CPME’

If you already have a corporate health plan in place which is on a fully underwritten, or moratorium basis, we can quote to provide cover in respect of your existing employees and their dependents on the same underwriting terms agreed by your previous insurer. This means that we will honour the medical acceptance terms issued by your current insurer, and any personal medical exclusions applied by your existing insurer will be continued on your policy with us.  All existing employees will keep the start date of their existing policy for the purpose of any moratorium periods or waiting periods meaning they would not need to re-qualify for benefits which are already available to them.

Please note that this continuation applies only to the medical underwriting terms at which each person has been accepted into your current insurer’s plan and will be subject to acceptance. The actual benefits, terms and conditions of our policy will replace those of your existing insurer. Future new employees and new dependants will be added to your policy on a Moratorium or Fully Underwritten basis. In order to set up cover on continuous terms, we will require copies of each employee’s current Certificate of Insurance as well as a copy of the current table of benefits.

Our requirements

• Business application form
• A membership census for all members to be covered
• The current certificate of insurance for the group including details of the existing underwriting and any terms which may apply
• Each individual employees’ certificate of insurance including the existing underwriting and any exclusions which may apply to them specifically
• Your current table of benefits
• Any new employees joining at the time the plan moves will need to complete the relevant application form for the type of underwriting used (typically FMU or Mori)

Your policy

Your William Russell plan will be one that closely resembles your existing plan from your current provider, giving you the same, or very similar, cover and terms and without requiring your employees to re-qualify for any benefits they already have or applying new terms to them just because the insurance provider has changed.

 

Medical History Disregarded

Sometimes referred to as ‘MHD’

Underwriting terms can make a big difference to your cover. If you require cover for pre-existing medical conditions and have 10 or more employees on the scheme, we can also consider offering cover with Medical History Disregarded (MHD). Subject to disclosures and acceptance by underwriting, MHD can provide cover for all pre-existing conditions including chronic conditions.

Our requirements

• Business application form
• Employee census
• Business form (short medical disclosure completed by the business, not by individual members)
• Business groups of 50+ will not be required to complete the business form mentioned above

Your policy

MHD underwriting is a good option for larger groups of employees to minimise the on-boarding process and paperwork.

The claims process experience is also generally quicker with MHD.