Members whose cover is in excess of the medical proof free limit are restricted to this limit until all medical requirements are received and the member is medically underwritten and accepted by the insurer.
The key requirements for the medical underwriting process are:
• Fully completed details on all medical forms. Blank fields or incomplete information results in delays in underwriting.
• To be notified when additional medicals have been completed. This is so that the doctor’s payment can be arranged and the completed medicals traced back to the underwriters.
• To be informed if a member would like a traveling nurse to come to them (i.e. in cases where only a pathology report and a short medical report are required). This is offered by all our insurers for the convenience of the member.
• To be informed if a member would like to do tele-underwriting for initial requirements. This is offered by Capital Alliance for the convenience of the member.
Our medicals team will inform you if further medicals are required and in this instance, the insurer will bear the cost according to the medical tariff rates. Please note that the insurers will cover the cost of any reports or evidence that they request but they will not pay for consultations.
A full premium is payable from the time a member or scheme’s cover commences and if a member is medically restricted, then a restricted premium may apply. Members can opt not to submit medicals, however, full premiums are payable and a signed Declaration of such will be required.
If you have any questions or would like to understand more about medical requirements, please contact us here.
Thank you and regards,
The TSA Team