Private Medical Insurance (Part 3): Switching Providers and Maintaining Underwriting Terms

Switching private medical insurance (PMI) providers can feel daunting, especially for businesses doing it for the first time. It’s completely normal to have questions about maintaining a similar level of cover, protecting underwriting terms, and making sure the new policy still meets your employees’ needs. When you also factor in things like pre-existing conditions or potential new exclusions, it’s easy to see why the process can feel uncertain.

In this article, we’ll look at two important things to keep in mind when switching private medical insurance providers:

1. How to maintain a similar level of cover (if that’s important for your business), and

   
   

2. What’s involved in protecting your current underwriting terms by meeting the new insurer’s switching criteria.

   
   

We’ll also touch on how a broker can support you through the process, and what kind of service you can typically expect when it comes to reviewing or changing your policy.

1. Maintaining a Comparable 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 could find a plan that’s a close fit—or even one that’s better aligned with how your business has evolved.

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 summaries 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. Protecting 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 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 without adding new exclusions to the members’ terms. These underwriting terms are usually outlined on each member’s certificate of insurance, which includes the start date, chosen underwriting type (such as moratorium or full medical underwriting), and any specific exclusions applied in addition to the insurer’s general exclusion list.

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 comparison 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 what a broker can support with, it’s best to speak to them directly and confirm what’s included.

Summary

If you're considering switching PMI 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 best 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.