Private health insurance: Common definitions within policies

Although there are certain ABI agreed definitions, this does not mean that all insurers uses them.

Each insurer offers a variation on this or no cover at all - as the guideline has no legal status.

Not all insurers are members of the ABI.

The golden rule remains, if unsure what cover an insurer will offer - ASK.

Acute condition

'A disease, illness or injury that is likely to respond quickly to treatment  which aims to return you to the state of health you were in immediately  before suffering the disease, illness or injury, or which leads to your full  recovery

Day patient

A patient who is admitted to a hospital or day patient unit because they  need a period of medically supervised recovery but does not occupy a bed  overnight

Diagnostic tests

Investigations, such as X-rays or blood tests, to find or to help to find the  cause of your symptoms.


A patient who is admitted to hospital and who occupies a bed overnight or  longer, for medical reasons.


A qualified nurse who is on the register of the Nursing and Midwifery  Council (NMC) and holds a valid NMC personal identification number

Out patient

A patient who attends a hospital, consulting room, or outpatient clinic and  is not admitted as a day patient or an inpatient


Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury

Note- some insurers use the term 'active treatment'. This has the potential to confuse customers given the current agreed definition of treatment.  If insurers insist on still using the term active treatment – they must fully explain what it is with a specific definition-they cannot leave the phrase hanging in mid air.

And also, providers of private medical insurance UK must;

Be clear about private medical insurance - when cover starts and ends, what is covered, and limits on benefits.

Treat all customer information as confidential



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