Underwritten Group Scheme Application Form

We offer different underwriting terms, depending on the size and needs of your group

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. Once a member has completed a continuous 24-month period after their start date, their pre-existing medical conditions may be covered, provided they have not had symptoms, needed or received treatment, medication, a special diet or advice, or had any other indications of the condition.

MORATORIUM APPLICATION FORM

We also offer conditional medical history disregarded terms 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.

 CONDITIONAL MHD FORM

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.