Private Medical Insurance (Part 3): Switching Providers Without Losing Your Underwriting Terms

Switching private medical insurance (PMI) providers can feel daunting—especially for businesses doing it for the first time. It’s perfectly natural to have questions about your benefits, cover levels, and underwriting terms, and to want reassurance that the new policy will continue to meet your employees’ needs. When you also consider factors like pre-existing conditions and potential new exclusions, it’s easy to understand why the process can seem complex.

This article is the third instalment in a three-part series designed to give you a solid understanding of the foundations of private medical insurance (PMI). Across the series, we’ve explored three key pillars: the general exclusion list, underwriting terms, and switching providers. By the end of this article, our goal is for you to feel more confident at your next renewal—equipped to explore different options and providers—so you can make the right decision for yourself, your family, or your company.

When considering a change of providers, there are usually two key elements to focus on. The first is maintaining a similar level of cover, and the second is ensuring a full transfer of your underwriting terms. In this article, we’ll take a closer look at these important considerations. We’ll also discuss how a broker can support you throughout the process, and what kind of service you can typically expect when reviewing or changing your policy.

1. Maintaining a Similar Level of Cover

While many private medical insurance (PMI) providers offer similar types of benefits, no two policies are the same. That means it might not be possible to match your current cover exactly when switching providers. However, you may find a plan that’s a close fit—or even one that aligns better with your business needs.

This is where a broker can really help. They can talk you through the differences between insurers, explain your options, and share useful documents like policy wordings and general exclusion lists to help you make an informed choice. Many brokers are also on hand to answer questions and guide you through each step of the switching process.

Comparing policies can get complicated, especially when it comes to the finer details. That’s why working with someone who specialises in private medical insurance can make a real difference when finding cover that works for your business.

2. Full Transfer of Your Underwriting Terms

   
   

Another key consideration when switching providers is whether your existing underwriting terms can be maintained. In many cases, insurers may offer the option to carry over underwriting terms, provided certain conditions are met. This process typically involves completing a switch declaration—a short form that includes medical questions, which the group administrator (GA) of the company policy is required to answer to the best of their knowledge.

If the Group Administrator (GA) can answer “no” to all the questions in the switch declaration, and the insurer is satisfied with the responses, the existing underwriting terms may be accepted on a full transfer. Each member’s underwriting terms are usually outlined in their certificate of insurance. This certificate typically includes the original start date—indicating how long the member has had continuous cover—their chosen underwriting type (such as moratorium or full medical underwriting), and any specific exclusions applied in addition to the insurer’s general exclusions.

Once the new insurer approves the switch and receives the signed documentation, they will usually require all members’ certificates of insurance from the current insurer. For business policies, major insurers typically have agreements in place to send these certificates directly to the new insurer once the group administrator (GA) on the policy has provided their consent. After the new insurer receives the certificates, they may apply the same terms to your new policy. This can help ensure that pre-existing conditions covered under your current plan remain covered for all eligible treatment with the new insurer. Additionally, your start date is often backdated to reflect the length of your continuous cover.

It’s important to confirm the switching requirements with your insurer or broker before making any changes. For more information on underwriting, please refer to our article, "Understanding the Different Types of Underwriting Terms," available on the blog page of our website.

The Role of a Broker

Switching providers involves careful consideration of both cover and underwriting. In some cases, a broker may be able to assist by helping you understand your current policy, comparing it with available alternatives, and supporting the switch process once a decision has been made.

Typical broker services can include:

• Reviewing your current policy and business requirements

• Conducting a market review based on your needs

• Highlighting key differences between providers and cover types

• Supporting the switch process once you make a decision

• Coordinating with insurers to help ensure your policy is set up correctly and that you receive the appropriate documentation

  
  

Please note: Not all brokers offer the same level of service. For specific information about the support a broker can provide, it’s best to speak with them directly and confirm the services they offer.

Summary

If you're considering switching providers, it's important to understand how your cover and underwriting terms may be affected. Working with a broker can help make the process more manageable, ensuring you have the right support as you weigh up your options. With a clear understanding of your current policy and your business’s needs, you’ll be in a strong position to make the right decision moving forward.

Disclaimers:

Disclaimer 1: The information provided in this article is accurate as of April 13, 2025. However, all details are subject to change in the future based on updates to insurer terms, market conditions, or regulatory changes. For the most up-to-date information, please contact a broker or your insurer directly.

Disclaimer 2: The information provided in this article is intended for educational purposes only and should not be used as specific advice for any individual insurer or policy. For details regarding your specific policy, always refer to your insurer’s policy documents or contact a broker or your insurer directly for personalised assistance.