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Statement of Best Practice for Sales of Individual and Group Private Medical Insurance

This Statement of Best Practice applies to ABI members selling private medical insurance (PMI) to UK residents that covers private treatment in the UK. 

It is designed to help make sure that people can make the right choice about which plan will suit their needs. It aims to help people: Get clear, timely information about policies they are considering Understand the extent and limitations of cover under the policies they are considering Compare key aspects of the cover offered by different insurers Choose the best underwriting approach and policy for their needs

This Statement covers individual, and group (including corporate) private medical insurance schemes. It requires insurers to: Use common definitions for specific terms. Use standard examples to explain the scope of cover. The examples about cancer were originally developed with Cancerbackup, now part of Macmillan Cancer Support, and we gratefully acknowledge their ongoing contribution. Make information available to individual and group applicants, or the intermediary, if there is one.

Private medical insurers are required to comply with all UK and EU legislation. They are also regulated by the Financial Services Authority. All information insurers provide must be clear, fair and not misleading. This Statement builds on the existing legislation and regulations to cover the specific information needs of people considering private medical insurance.

This Statement is in addition to (and, in the event of a conflict, is overruled by) any regulatory or legal requirements and is mandatory for all private medical insurers that are ABI members. It can therefore be taken into account by the Financial Ombudsman Service in considering any complaints about private medical insurance.

This Statement supersedes and replaces all previous editions. Members should implement the revised Statement as soon as possible, but in any event within eighteen months, as necessary to accommodate IT updates and publication cycles.

Last updated 01/07/2016