How group underwriting differs from an individual policy

What the term means

Medical history disregarded underwriting, usually shortened to MHD, is a basis on which an insurer agrees to cover every member of a group scheme from the day they join, without asking any of them to declare past medical history. A condition an employee already had before the scheme started is covered on the same terms as one that develops later.

That is a different starting point from how an individual policy is normally underwritten, where a past condition is far more likely to be excluded or loaded. On a scheme written on MHD terms, the insurer takes on that risk across the whole group.

Why headcount decides whether it is on offer

Insurers set MHD underwriting against the size of the group, because spreading the risk across more people is what makes it workable for them to skip individual medical questions. Brokers report that MHD cover usually needs at least 20 employees on the scheme (Drewberry, read 4 October 2026).

Below that kind of headcount, an insurer is less able to offer MHD and is more likely to underwrite each member individually, or offer the scheme on a different basis. The threshold sits in each insurer's own scheme terms, is set by the insurer, and can change over time.

For a company close to that size, headcount is the first thing worth checking before assuming MHD terms will be on offer, and before any conversation with an insurer or broker begins.

Moratorium underwriting handles pre-existing medical conditions without asking each employee to fill in a full medical questionnaire when they join the scheme. The employee is covered from day one for anything new, while any condition they had symptoms of, took treatment for, or were advised about before joining is excluded for a set period, as set out in the policy terms.

How the exclusion period works

If the employee has no symptoms, treatment or medical advice for the excluded condition during that period, it is then usually brought into cover without any further underwriting being needed. If symptoms come back or treatment is needed within the period, the condition tends to stay excluded and the period can start again from that point.

What this means at claim time

Because nothing is declared at the outset, a claim for a pre-existing condition is checked against the employee's medical history only when that claim is actually made. That means a claim can be assessed, and potentially turned down, some time after the employee joined the scheme.

When insurers offer it

Moratorium underwriting is one of the underwriting bases insurers publish as an alternative to medical history disregarded cover. Which basis is available to a particular group, and what exclusion period applies, is set out in that insurer's own scheme terms.

When someone joins a group scheme already holding an individual private medical policy, the insurer does not always treat them as a fresh medical history. Where that earlier policy excluded a condition, the group insurer can carry the same exclusion forward. This carried-forward exclusion is what insurers call a continued personal medical exclusion (CPME).

The practical effect is that the exclusion does not reset just because the cover has moved from an individual policy to a company scheme. If a knee condition was excluded under the old policy, it stays excluded under the new one, even where the rest of the group is being underwritten on medical history disregarded or moratorium terms.

For whoever is setting up the scheme, this matters because the underwriting terms agreed for the group as a whole are not automatically what every individual gets. An employee arriving with an existing policy and an existing exclusion can end up on different terms from a colleague starting with no prior cover at all, and that is worth knowing before assuming the group terms apply evenly to everyone on the scheme.

Private medical cover under a group scheme is tied to being a member of that scheme. When someone leaves the company, or the employer removes them from the scheme, the cover itself usually stops on that date. What happens next depends on the underwriting basis the group scheme was set up on, and on what the insurer is prepared to offer a leaver individually.

Medical history disregarded cover does not travel with the person

Medical history disregarded (MHD) underwriting lets everyone who joined the scheme at outset get cover for pre-existing conditions without being asked about their medical history. That basis belongs to the group policy. If the same person leaves and wants their own personal policy, the insurer offering it is not bound by the group scheme's underwriting basis and can ask about health history from scratch.

In practice, this means a condition that was quietly covered under the group scheme's disregarded-history basis can resurface as a question, or an exclusion, on an individual application.

What some insurers offer leavers instead

Some insurers address this by offering a leaver a personal policy on continued personal medical exclusions (CPME): any exclusion that already applied to that person under the group scheme carries across to the personal policy. This protects the leaver from being excluded on conditions they were not previously excluded for.

It does not mean everything the group scheme covered is guaranteed to continue. A condition that was only covered because the group scheme disregarded medical history is not automatically carried forward on this basis.

Whether continued exclusions are offered, and on what terms, is set by each insurer, so it is worth checking the scheme's own leaver terms, or asking the insurer directly, before assuming cover will continue in any particular form.