Underwritten Group Scheme Application Form

Moratorium underwriting

Moratorium underwriting sets a waiting period for pre-existing medical conditions to limit the insurance risk. This means that you won't need to tell us about pre-existing conditions of any member to be covered when you apply and there will be a 24-month waiting period before claims for any pre-existing medical conditions may become eligible.



Conditional Medical History Disregard (MHD)

We also offer conditional medical history disregard term to  groups of 5 to 9 employees. For those, we will ask each person to be covered  to complete a medical questionnaire, telling us about their medical history. Our underwriting team  will then review each form and decide if medical history disregarded terms can be offered.


underwritten group scheme

If you are a group scheme member who pays for all or part of your healthcare premium, and you choose to pay by Direct Debit, please complete and submit the appropriate Direct Debit Mandate below.

For payment in Euro, please complete the SEPA Direct Debit Mandate.
For payment in Sterling, please complete the GBP Direct Debit Mandate.
For payment in Swiss Franc, please complete the CHF Direct Debit Mandate.