Glossary of Terms for Private Medical Insurance

To the lay person Insurance documents are full of jargon but the detailed meanings in your policy are very important. Here is a list of private medical insurance terms set out by The Association of British Insurers:


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.'

Cancer
'A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue.'

Chronic condition
‘A disease, illness, or injury that has one or more of the following characteristics:
• it needs ongoing or long-term monitoring through consultations, examinations, check-ups, and / or tests;
• it needs ongoing or long-term control or relief of symptoms;
• it requires your rehabilitation or for you to be specially trained to cope with it;
• it continues indefinitely;
• it has no known cure;
• it comes back or is likely to come back.’

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.'

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

Nurse
'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.'

Pre-existing condition
'Any disease, illness or injury for which:
• you have received medication, advice or treatment; or
• you have experienced symptoms;
whether the condition has been diagnosed or not in the xxx years before the start of your cover.
(the same period is not common to all insurers)'

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

It is important to note that each health insurance company will have their own specific set of terms which it is important for the consumer to become familiar with.